Tag Archives: Bryan Jepson

Autism’s False Prophets by Paul A. Offit, MD, a review

Autism’s False Prophets: Bad Science, Risky Medicine, and the Search for a Cure, by Paul A. Offit, MD.

Published by Columbia University Press, 2008, 247 pages.

Offit, a doctor who is a proponent and inventor of vaccines, tells a sad tale of desperate parents of autistic children falling for charlatans. He details one death (from botched chelation) and plenty of wasted money, and lots of wasted breath on the subject of thimerosal and the MMR vaccine as causes of autism.

Offit has waded right into this controversy. He does some name-calling in the subtitle of his book, and ridicules those who disagree with him, suggesting they can’t count.

Here’s his summary (p. 247):  “The science is largely complete.  Ten epidemiological studies have shown MMR vaccine doesn’t cause autism; six have shown thimerosal doesn’t cause autism; three have shown thimerosal doesn’t cause subtle neurological problems; a growing body of evidence now points to the genes
that are linked to autism; and despite the removal of thimerosal from vaccines in 2001, the number of children with autism continues to rise.”

Offit says that epidemiological studies have refuted two vaccine-related hypotheses:

* that thimerosal, a mercury additive, causes autism, and
* that the measles virus in the MMR shot causes autism.

He lists a number of epidemiological (population-wide) studies to back these up.  He goes into absolutely no detail though. Bryan Jepson, MD, in his book Changing the Course of Autism, goes into plenty of details questioning these studies.  I would like to challenge Offit to respond to Jepson’s analysis, line by line.

Offit’s tone is most offensive when he quotes anti-vaccine activist and parent  Jenny McCarthy as saying “in 1983, there were 10 vaccines. Now there are 36.”  Offit then counts 7 in 1983 and 14 today and names them–polio, measles, etc.  Then Offit says “Misstatements of fact didn’t seem to matter. Thirty-six vaccines, 14 vaccines, close enough.”(p. 242-3)

Now, I know she is counting shots or sticks, like any mother would, while he is counting the several shots and boosters required for each disease as one vaccination.  He’s comparing apples to oranges and then adding a put-down. Does this make her look bad, or him?

Now, let’s look at his logic. He says that many studies are showing that neither thimerosal nor the measles virus from the MMR shot causes autism. Therefore, Offit says, vaccines don’t cause autism.

Whoa, Nelly. There are many more features of vaccines than just these two that could possibly cause autism. This is precisely Jenny McCarthy’s point: even if thimerosal and the measles virus are not to blame, the sheer number of vaccines being given our tiny children with immature immune systems could be causing autism, in some way not fully understood.  THIS question has not been the subject of a study yet, I believe.  Such a study would use epidemiology to compare a vaccinated population with an unvaccinated one.  There are such vaccinated populations:  Amish, and a home-birth medical practice that has delivered 30,000 children in Chicago. This study needs to be done, if the vaccine controversy is going to go away.

Here’s the reason why we need to do this study–we can all see that the autism rate has been rising with the number of vaccines given, as Jenny McCarthy was pointing out.  Even if we don’t have a theory of exactly HOW the vaccines may cause autism, the vaccines could still be causing it.

Offit thinks the cause of autism must be genetic.  Researchers are finding a collection of mutations that appear to be linked to autism. Actually my family has participated in this research. In our case, there clearly is a genetic component, with autism occuring in two generations.

But an epidemic CANNOT have a sole genetic cause. This is more logic. Mutations don’t just  start happening like crazy all by themselves. There has to be something in the environment that has changed, and that started changing significantly around 1990.

I think that many or most of the kids affected by the epidemic have only a minimal genetic tendency, and that a toxin of some kind is to blame.  For these kids, “recovery” is possible. I say this because I know moms of kids through the Internet whose kids are recovered. Jenny McCarthy’s son is recovered. In fact you
can see before and after videos  of recovered kids.  Treatments varied, but the result is the same.

Now, Offit plays the video card the other way. He cites a study where researchers looked at baby videos of older kids who are autistic. In their baby videos the researchers found autistic traits even before the age of 1. Therefore, Offit says, the MMR shot, given after the age of 1, isn’t to blame.  Well, I guess he can have that point. But he needs to look at the before and after videos of these other kids, the ones who are recovered. Offit actually denies that recovery is possible and praises parent activists who take this position as well.

And while he thinks autism must be genetic, he completely ignores the work of Defeat Autism Now! (DAN!) doctors and Amy Yasko on providing supplements to fill in the gaps in mitochondrial cycles such as the methylation cycle, gaps caused by genetic mutations.  The DAN!/Yasko approach is purely pragmatic — sketch the possible cycle problem, and try a supplement to fix it. If it works, keep it.  Offit is a theorist, and isn’t into pragmatics. He also doesn’t have an autistic child who is rapidly growing up, like many of the DAN! doctors do.

It’s been a long and vicious controversy. Offit carefully details it –how English doctor Andrew Wakefield, the first to link autism to the MMR vaccine, falsified data and was ultimately stripped of his medical license in the UK. How the possible thimerosal link was sensationalized, with the only supporting lab data available based on non-human studies. How both hypotheses are apparently proved wrong by a number of epidemiological studies (but he gives no details, as I said).

Then he describes various situations where charlatans have hoodwinked the public, and says that that is what is going on here.  Apparently he wants us parents to sit and wait while our kids are growing up, until the medical community comes up with a cause and then a cure. Never mind that the research being funded is aimed at genetic causes, not environmental.  Never mind that autism research is amazingly poorly funded, given the size of the epidemic. Never mind that our kids will be grown up in the meantime.

I am sad that the kids are losing out, as result of all this crossfire.  I hope that researchers will move their focus to a variety of environmental factors that could be causes, including the greatly increased use of plastics since 1990.

Especially I would like to see the epidemiological study I mentioned before, comparing vaccinated and unvaccinated populations.  The reason is the preponderance of anecdotal evidence that children become autistic soon after vaccination. And that’s not just for the MMR vaccine.

And what’s a parent to do? Since some kids are recovering, I believe it’s my responsibility as a parent to find out what I can and try what I can afford.  We do need to be cautious, especially not doing anything that could possibly hurt our children.  We need to be wise.  We need to share what works with each other. We do need to heed Offit’s warning that there are people out there ready and willing to prey on us.

Offit’s allies are parents whose primary motivation seems to be concern about hurting a child’s feelings by telling the child he’s in need of a cure.  That must be a bit hard on the self-esteem, I agree. These parents prefer to emphasize the special abilities that come with autism, including unusual memory.

So, here’s the question:  Does your child know he is different? If your child had the opportunity to choose, what would he or she choose? To seek a cure or not?

Well, I have a 21-year-old daughter with Asperger’s who has made this choice herself, after turning 21. She has chosen to go to the DAN! doctor and take the supplements. She is proud of her special abilities in memory and oddball sense of humor. But she has a sense of adventure, too.

That’s what we all need to do, we parents of kids with autism:  figure out what the kids would want, if they were old enough to choose. –Phyllis Wheeler

The Pro-Vaccine Side Writes a Book

The pro-vaccine forces have now written a book, Autism’s False Prophets by Paul A. Offit, reviewed in a kindly manner Jan. 12 by Donald G. McNeil Jr. of the New York Times at http://www.nytimes.com/2009/01/13/health/13auti.html?_r=2&scp=2&sq=Autism&st=cse

One of the arguments advanced by Offit and others interviewed, is that the autism epidemic is caused by genetics.  However, it appears only logical to me that no epidemic can have only genetic causes.  There must be other causes as well.

Several people quoted in the article say that the research proves vaccines are not tied to autism. However, the book by Bryan Jepson, MD, which I have been studying goes over these studies in detail and shows the flaws. There are plenty of flaws.  Jepson’s conclusion: nothing at all has been proven so far.  Offit’s conclusion:  vaccines are vindicated.  Both these men are respected MD’s.  I’m going with Jepson’s careful, step by step analysis of studies supporting both sides.

How about the argument that vaccines overwhelm babies’ immune systems?  The New York Times says, “Dr. Offit notes that current shots against 14 diseases contain 153 proteins, while babies cope with thousands of new foreign proteins daily in food, dirt and animal hair, and that the smallpox vaccine that nearly every American over age 30 got as a child contained 200 proteins.”

This seems to me to be unrelated information.  We are not talking about harmful proteins. We are talking about harmful viruses.  Jepson describes a study by English researcher A.J. Wakefield.  Wakefield’s theory is that the measles virus creates an abnormal immune response. The damaged immune system then allows the measles virus to linger in a subacute, chronic state, causing gut inflammation. The resulting holes in the intestinal wall allow various toxins to pass into the bloodstream, causing secondary brain injury and subsequent autism.

Jepson (p. 82) describes a study Wakefield did, published in 2002 in Molecular Psychiatry, looking at 91 autistic patients. He tested for measles virus RNA in the ileal lymph nodes next to the small intestine.  Seventy-five of these 91 autistic children had the measles virus RNA in these lymph nodes. Of kids in the control group, only five of 70 had measles RNA in these lymph nodes. Now, that’s a significant difference.

Jepson (p. 82) quoted another researcher, P. Ashwood, who used a different method and confirmed measles-virus antigen in 87.5 percent of ilial biopsy specimens from 10 autistic children, compared to none found in the 18 controls.  The researchers tested for other viruses (rubella, mumps, adenovirus, herpes simplex 1 and 2, and HIV) but did not find them. Ashwood’s study has not been published, according to Jepson’s notes.

The remaining question, wrote Jepson, was whether the measles RNA found was from a vaccine or from a “wild” strain.  Japanese researchers isolated measles virus from blood samples from a small group of autistic children. In every case, the RNA sequence was consistent with the vaccine strain, wrote Jepson (p. 83)  This study by Kawashima H. et al was published in the journal abbreviated Dig Dis Sci in April, 2000.

I hereby challenge the New York Times reporters to read Jepson’s book before they write any more. And also, stop the bias. I can see a bias just from the teaser at the end of the NYT article:

“Next week: In the Personal Health column, Jane E. Brody will write about efforts, so far fruitless, to find a cure for autism.”

There–the newspaper has already judged that the efforts to find a cure are fruitless.  I challenge Jane Brody to watch the videos I posted a few days ago (http://technorati.com/videos/youtube.com%2Fwatch%3Fv%3D-fouye8Y4bg), documenting the recovery of several children.  She needs to demonstrate to me that she is following the expected journalism ethics of impartiality.  I am not seeing it, currently.–Phyllis Wheeler

Source:

Jepson, Bryan, MD, and Jane Johnson, Changing the Course of Autism, Sentient Publications, 2007, 354 pages

One in Six

I am thinking about this book I just read. Bryan Jepson, M D, wrote Changing the Course of Autism, publishing it in 2007. He reported that in 2004 the CDC “published an autism ‘ALARM,’ acknowledging that the current rate of autism spectrum disorders in the US was one in 166.”

The most alarming statistic though is this one:   Also in 2004, the CDC noted that a developmental disability and/or behavior problem was being diagnosed in one child out of every six.

A few years have passed; now it is 2009. But there isn’t any evidence that the epidemic is slowing down. The graphs in Jepson’s book all show rising rates of change.

The Hidden Horde Theory

I was writing previously about my friend who challenged me, saying she thinks that there isn’t a real increase in autistic kids–just an improvement in diagnosis.

There’s a logical argument that refutes her claim. It’s called the Hidden Horde Theory.

I am reading a book, Changing the Course of Autism by Bryan Jepson, MD.  This book is full of information on studies related to autism, and is particularly aimed at physicians. However, it is readable by a lay person and in fact should be read by anyone puzzling over what is known about autism at this point.

Jepson presents plenty of statistics, including a detailed study of kids in California, that makes it very clear that there are many, many autistic kids now–one in 166 in the US as reported by the Center for Disease Control in 2004. The CDC also reported that one child in six is being diagnosed with a developmental disability or behavior problem.

Here’s the conundrum: if there were that many undiagnosed autistic kids 30 years ago, there would be a horde of them out there as undiagnosed or misdiagnosed adults now.  “Autism is disabling, and individuals would end up where society deposits the mentally ill: outpatient psychiatric clinics, mental institutions, homeless shelters, or prisons,” says Jepson (p. 37).

Nylander and Gillberg screened adults in Sweden at outpatient psychiatric facilities looking for undiagnosed cases of autism.  They assumed they would find some. In fact they found 19 people who met autism criteria who were previously undiagnosed.  But that brought the prevalence rate to only 2.7 per ten thousand, similar to other developed country population prevalence rates for autism before 1980.

No one has found the hidden horde, although others besides Nylander and Gillberg have looked, says Jepson.

Meanwhile, the number of autistic kids now diagnosed is going to overwhelm our social care systems.  Even if no more autistic kids were born starting now, the long-term care for those already leaving (estimated at $3.2 million per person over a lifetime) could absorb, and then bankrupt, the federal social services budget, says Jepson (p. 40).  As of September, 2006, the number of people with full-criteria autism receiving services in California was 31,853.

References:

Jepson, Bryan, MD, and Jane Johnson, Changing the Course of Autism, Sentient Publications, 2007, 354 pages

Nylander L, Gillberg c. Screening for autism spectrum disorders in adult psychiatric outpatients; a preliminary report. Acta Psychatr Scand 2001 June;103(6):428-34.